Subcutaneous fat necrosis of the newborn is a rare form of lobular panniculitis occurring in newborns that is usually self-remitting and non-recurring. Proposed causes include perinatal stress, local trauma, hypoxia and hypothermia, though the exact cause is unknown. It has been suggested that the brown fat seen in newborns is more sensitive to hypoxic injury than fat seen in adults, and that such hypoxia, usually in the context of a complicated birth, leads to the fat necrosis. Complications can include hypercalcemia, hyperlipidemia, dehydration, hypoglycemia, seizures, vomiting, constipation, and thrombocytopenia, and can present months after the onset of SCFN symptoms.[1][2]: 490 [3]
| Subcutaneous fat necrosis of the newborn | |
|---|---|
| Other names | SCFN or SFN |
| Specialty | Pediatrics  |
Signs and symptoms
editSubcutaneous fat necrosis of the newborn (SCFN) occurs in full-term newborns usually in the first six weeks of life as indurated plaques or erythematous to violaceous nodules on the cheeks, back, buttocks, or proximal extremities. Usually, the abdomen and chest are unaffected.[4] There has been a case report of SCFN with localized scalp alopecia covering an erythematous nodule.[5] Tenderness is common in lesions.[6]
About 50% of newborns with subcutaneous fat necrosis of the newborn (SCFN) experience hypercalcemia, a potentially fatal consequence.[7] Some infants with SCFN experience anemia, hypoglycemia, thrombocytopenia, and elevated triglycerides.[8][9] Rarely, thrombocytosis is seen in infants with SCFN.[10]
Causes
editAlthough the exact cause of the newborn's subcutaneous fat necrosis is unknown, several systemic maternal diseases, including preeclampsia and diabetes, as well as asphyxia, hypothermia, meconium aspiration, and obstetric trauma, may act as precipitating factors in the development of SCFN.[7]
Diagnosis
editA skin biopsy and the clinical presentation must both be taken into account for the most accurate diagnosis.[11] But in order to prevent skin biopsy, ultrasonography examination has been shown to be useful in identifying the newborn's subcutaneous fat necrosis when combined with Doppler blood flow analysis; this usually indicates a subcutaneous high echo signal, either with or without calcifications.[12]
See also
editReferences
edit- ^ Matar, Marla M. (2021). "A Case Report and Anesthetic Considerations in Subcutaneous Fat Necrosis of the Newborn". A&A Practice. 15 (3): e01422. doi:10.1213/XAA.0000000000001422. PMID 33684082. S2CID 232160504.
- ^ James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. ISBN 978-0-7216-2921-6.
- ^ Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 978-1-4160-2999-1.
- ^ "UpToDate". UpToDate. Retrieved February 17, 2024.
- ^ Xu, Ziyang; Rubin, Adam I.; Oboite, Michelle (June 18, 2021). "Subcutaneous fat necrosis of the newborn presenting as circular alopecia: a novel presentation". Pediatric Dermatology. 38 (4). Wiley: 982–983. doi:10.1111/pde.14664. ISSN 0736-8046. PMID 34145911. S2CID 235481677.
- ^ Mahé, E.; Girszyn, N.; Hadj-Rabia, S.; Bodemer, C.; Hamel-Teillac, D.; De Prost, Y. (2007). "Subcutaneous fat necrosis of the newborn: a systematic evaluation of risk factors, clinical manifestations, complications and outcome of 16 children". British Journal of Dermatology. 156 (4). Oxford University Press (OUP): 709–715. doi:10.1111/j.1365-2133.2007.07782.x. ISSN 0007-0963. PMID 17493069. S2CID 29283658.
- ^ a b Stefanko, Nicole S.; Drolet, Beth A. (September 6, 2018). "Subcutaneous fat necrosis of the newborn and associated hypercalcemia: A systematic review of the literature". Pediatric Dermatology. 36 (1). Wiley: 24–30. doi:10.1111/pde.13640. ISSN 0736-8046. PMID 30187956.
- ^ Del Pozzo-Magaña, Blanca R.; Ho, Nhung (August 30, 2016). "Subcutaneous Fat Necrosis of the Newborn: A 20-Year Retrospective Study". Pediatric Dermatology. 33 (6). Wiley. doi:10.1111/pde.12973. ISSN 0736-8046. S2CID 44286466.
- ^ Tran, Julie Thao; Sheth, Anita P. (2003). "Complications of Subcutaneous Fat Necrosis of the Newborn: A Case Report and Review of the Literature". Pediatric Dermatology. 20 (3). Wiley: 257–261. doi:10.1046/j.1525-1470.2003.20315.x. ISSN 0736-8046. PMID 12787278. S2CID 26678688.
- ^ Sahni, Mitali; Patel, Pooja; Muthukumar, Akila (February 22, 2020). "Severe Thrombocytosis in a Newborn with Subcutaneous Fat Necrosis and Maternal Chorioamnionitis". Case Reports in Hematology. 2020. Hindawi Limited: 1–3. doi:10.1155/2020/5742394. ISSN 2090-6560. PMC 7056997. PMID 32148979.
- ^ Fajgenbaum, Kristen; Zeitany, Alexandra; Googe, Paul B.; Morrell, Dean S.; McShane, Diana (July 9, 2018). "Firm, Indurated Plaques After Therapeutic Hypothermia". Clinical Pediatrics. 57 (12). SAGE Publications: 1468–1471. doi:10.1177/0009922818785992. ISSN 0009-9228.
- ^ Tognetti, Linda; Filippou, Georgios; Bertrando, Sara; Picerno, Valentina; Buonocore, Giuseppe; Frediani, Bruno; Fimiani, Michele; Rubegni, Pietro (December 10, 2014). "Subcutaneous Fat Necrosis in a Newborn after Brief Therapeutic Hypothermia: Ultrasonographic Examination". Pediatric Dermatology. 32 (3). Wiley: 427–429. doi:10.1111/pde.12454. ISSN 0736-8046. PMID 25491115. S2CID 29137741.
Further reading
edit- Lara, Leire González; Villa, Asunción Vicente; Rivas, María Mercedes Otero; Capella, Mariona Sunol; Prada, Fredy; Enseñat, María Antonia González (2017). "Subcutaneous Fat Necrosis of the Newborn: Report of Five Cases". Pediatrics & Neonatology. 58 (1). Elsevier BV: 85–88. doi:10.1016/j.pedneo.2014.06.010. ISSN 1875-9572. PMID 28237247.
- Mitra, Subhabrata; Dove, Jennifer; Somisetty, Sateesh Kumar (2011-02-12). "Subcutaneous fat necrosis in newborn—an unusual case and review of literature". European Journal of Pediatrics. 170 (9). Springer Science and Business Media LLC: 1107–1110. doi:10.1007/s00431-011-1405-x. ISSN 0340-6199. PMID 21318229. S2CID 23109123.